ABSTRACT
A patient with haemolytic disease of the newborn (HDN) due to anti-M which required exchange transfusion is described. Anti-M antibodies are usually assumed to be naturally occurring and to consist of immunoglobulin M (IgM); many however have an immunoglobin G (IgG) component. In view of this and the described occurrence of HDN, recommendations are made regarding the management of a pregnancy in which anti-M antibodies are detected.
Subject(s)
Erythroblastosis, Fetal/blood , Isoantibodies/blood , MNSs Blood-Group System/immunology , Adult , Erythroblastosis, Fetal/therapy , Exchange Transfusion, Whole Blood , Female , Humans , Infant, Newborn , Pregnancy , Pregnancy ComplicationsSubject(s)
Pregnancy, Ectopic/epidemiology , Adolescent , Adult , England , Female , Humans , PregnancyABSTRACT
A randomised crossover trial was performed in 55 pregnant women who complained of heartburn to see whether alkali or acid treatment alleviated it. Each woman was given a week's treatment with an acid mixture, an alkali mixture, and a placebo in randomised order. Both acid and alkali mixtures were better than placebo, but there was no significant difference between the acid and alkali treatments. Together with the inconsistent reports of some patients, these findings suggest that both acid reflux and bile regurgitation may cause heartburn in pregnant women and that other factors may also play a part. Because the cause of heartburn may be difficult to determine, treatment should be empirical. If the patient does not respond to seven days' acid treatment an alkali mixture should be prescribed; there is a 98% chance that one of these treatments will relieve symptoms.
